Anecdotally known as “oops” babies, unexpected pregnancies are being reported by women using popular weight loss drugs such as Ozempic and Wegovy. These cases include women using oral contraceptives or previously diagnosed as infertile. Scientists suggest that these accounts should not be ignored, as there is mounting evidence that semaglutides like Ozempic may increase fertility.
The Theories
Doctors are intrigued by these pregnancies, considering potential alternative uses of such drugs but also expressing concern over the lack of concrete data. The science journal Nature indicates that there are valid reasons to believe Ozempic and similar drugs could enhance fertility, though the precise mechanism remains unknown.
One theory posits that these drugs might reduce the effectiveness of oral birth control while simultaneously enhancing fertility. Another theory suggests that obesity disrupts the menstrual cycle, which could normalize after weight loss induced by these drugs.
Research Findings
A 2015 Italian study found that dosing female rats with GLP-1 or semaglutide, the class of medications to which these drugs belong, triggered ovulation and increased the number of viable offspring compared to untreated rats. Furthermore, a Chinese study published in Nature Metabolism in May identified a species of gut bacteria, Bacteroides vulgatus, that regulates natural GLP-1 production in mice. The study found that these bacteria suppressed GLP-1 hormone production, disrupting ovarian function. Treatment with a GLP-1 drug restored ovulation in these mice.
In the US, rising numbers of unintended pregnancies among women on GLP-1 drugs have led some GPs to prescribe them for treating polycystic ovary syndrome (PCOS), a leading cause of infertility. Canadian endocrinologist Alyse Goldberg notes that the increasing use of GLP-1 drugs among young women of reproductive age (about 75% of users aged 18-25 are female) could significantly raise the risk of pregnancy.
The Australian Context
Australia has not yet seen a significant increase in Ozempic babies. Matt Vickers, clinical director of online health start-up Eucalyptus, reports no identifiable trend in this country. “We screen for patients that are actively trying to conceive before commencing GLP-1 medications. Being overweight or obese is a major risk factor for sub-fertility in men and women, and many patients aim to lose weight to improve their chances of conceiving,” Dr. Vickers said.
In the US, preliminary evidence suggests no increased risk of birth defects among those who used GLP-1 drugs early in pregnancy compared with those who took insulin. A US study involving 50,000 women with type 2 diabetes found no increase in birth defects among those who used the drugs early in pregnancy.
Market Impact
Goldman Sachs estimates that the global market for Ozempic and similar drugs will reach $US100 billion ($150 billion) annually by 2030. In Australia, telehealth companies like Eucalyptus and Midnight have responded to the high demand, providing compounded replica versions of the drugs. However, the Therapeutic Goods Administration has committed to shutting down this form of supply by October, a decision that can only be overturned by a Senate vote.
Conclusion
The phenomenon of “Ozempic babies” highlights a potential side effect of popular weight loss drugs that may inadvertently enhance fertility. While further research is needed to understand the mechanisms and implications fully, the anecdotal evidence and preliminary studies suggest that these drugs could play a role in unexpected pregnancies. As the market for these medications continues to grow, addressing these findings will be crucial for both healthcare providers and patients.
